| Palm Beach Osteopathic Care, Inc. | |
|
10887 N Military Trl Ste 5 Palm Beach Gardens FL 33410-6528 | |
| (561) 324-9600 | |
| (561) 799-9980 |
| Full Name | Palm Beach Osteopathic Care, Inc. |
|---|---|
| Speciality | Neuromusculoskeletal Medicine & OMM |
| Location | 10887 N Military Trl Ste 5, Palm Beach Gardens, Florida |
| Authorized Official Name and Position | Deborah Dodge (AM) |
| Authorized Official Contact | 5613249600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Palm Beach Osteopathic Care, Inc. 10887 N Military Trl Ste 5 Palm Beach Gardens FL 33410-6528 Ph: (561) 324-9600 | Palm Beach Osteopathic Care, Inc. 10887 N Military Trl Ste 5 Palm Beach Gardens FL 33410-6528 Ph: (561) 324-9600 |
| NPI Number | 1497964407 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 11/16/2020 |
| Medicare PECOS PAC ID | 6901875657 |
|---|---|
| Medicare Enrollment ID | O20040929000395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497964407 | NPI | - | NPPES |
| OS9152 | Other | FL | FLORIDA MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | OS9152 (Florida) | Secondary |
| 204D00000X | Neuromusculoskeletal Medicine & Omm | OS9152 (Florida) | Primary |
| Provider Name | Stanley Iii Wisnioski |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1043399900 PECOS PAC ID: 4688643331 Enrollment ID: I20040930000565 |
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